Ultrasound is a quick and relatively simple procedure. They could get a few in the ER and a few technicians on staff. Then doctors are encouraged to say bloodwork is off let's do an ultrasound and there you have it - $4k / 25 minutes. Bill the insurance and keep raking in the money.

Normally I'd say that's far fetched but after having relatives advised to get unnecessary surgery I wouldn't be surprised.

I'm not sure what you mean by the doctors being encouraged but unless the doctor ordering the U/S is getting a cut then there is no direct incentive. But I don't know how your system works so I might be wrong.

In some emergency departments, the physicians participate in profit sharing. I know of a few EDs where they add up all the revenue, subtract all the costs, and divide the rest into each doctor's paycheck based on how much that doctor billed each month.

Do you not understand that doctors have levels of management above them? Their incentive could be "Boss wants me to encourage them for X reasons"

This is basically the reason I have Kaiser and have stuck with them for over a decade. The quality of service is shaky sometimes, and there is doctor turnover, and sometimes I have to travel relatively far to see a specialist - but if a KP physician refers me for something, I get scheduled to see someone, then I get it done, and I pay a reasonable copay that I know about immediately. I've never had to haggle with insurance or been surprised with fees later, even for relatively complex surgeries.

I left Kaiser. As far as I can tell, they don't have any doctors. I've been told that if I yell at them repeatedly, they could get me one, but I don't have time for those shenanigans. I went there for a GI issue. They poked my belly and said, "It's a virus". Had I not figured out the issue on my own, it could have become life threatening. Several coworkers know people that have been misdiagnosed and lost loved ones because of Kaiser. It seems to me that Kaiser is an entry level place for new doctors to get some experience. The offices are tiny and everything is rushed.

Yet, I've heard on HN so many people love that place. I can't fathom how that is the case. Even military clinics are decades ahead of Kaiser.

The only positive thing I have seen about Kaiser is that they are an amazing drug company. Each campus has 2 to 4 pharmacies. That must be a very lucrative business.

Goddamn, are you me? I have the exact same story. Minor blood test anomaly, liver ultrasound, 30 minutes, surprise $6,000 bill. Pretty sure it's the same hospital too.

The only thing that would make it weirder is if the initial bloodwork happened to have been also ordered and checked by a doctor from your company's 'health center'.

My wife is scheduled for ultrasound #4 because of pregnancy irregularities. The fact that it's covered by universal healthcare gives me peace of mind in a few ways: I don't have to worry about affording it, I can just worry about keeping my family healthy. I don't have to doubt if the medical experts have my family's interests at heart or if it's just a cash grab.

First pregnancy we had a scare about genetic issues. Instead of wondering where the money would come from, I was able to take time off work and be there for my wife between the phone call and the battery of tests done 45 mins away. Another hour long ultrasound and a sit down with a geneticist in the afternoon. No bills, invoices, anything.

There's simply no reason for capitalism in healthcare to directly involved the patient. At least I believe that to be true.

  There's simply no room for capitalism in healthcare

Yet the very technologies you specifically required in both cases (ultrasound and genetic screening) are direct results of capitalism in healthcare.

Medical Ultrasound was pioneered by a UK university in conjunction with the NHS. Are you giving "capitalism" broad credit for everything in modern society or is there some more specific claim you're making here?